Culture

1
Culture

• NUR 210
• M.Sharpe, RN, MSN, NP

2
CULTURE

• Collection of beliefs, values, behaviors,
  rituals, habits shared by a group of people and
  passed from one generation to the next
• LEARNED FROM BIRTH
• SHARED BY ALL MEMBERS
• MOLDED BY ENVIRONMENT
• SUBCULTURES

3
Common Characteristics

• Universality
• Uniqueness
• Stability

• Changeability
• Unconsciousness
• Variability

4
Ethnocentrism

• The belief that ones cultural, ethnic, or
  professional group is superior to that of others

5
Stereotyping

• Exaggerated beliefs and images that are popularly
  depicted in the mass media, folklore, and general
  conversation.

6
Cultural Blindness

• Failure to acknowledge cultural differences

7
Cultural Shock

• Immobilization due to cultural differences

8
Cultural Diversity

• Myth of the melting pot is being displaced with
  a sense of identity among various ethnic groups

9
Acculturation

• The changes of ones cultural patterns to those
  of the host society (assumed to take 3
  generations in the US)

10
Racism

• Belief that people can be classified on the basis
  of biophysical traits that indicate innate
  inferior or superiority
• Prejudice unfavorable attitudes toward an
  individual or group of people based on
  unfavorable attitudes toward that group
• Discrimination differential treatment of an
  individual or a group based on unfavorable
  attitudes toward the group

11
Transcultural Assessment Model

• Communication
• Space
• Social organization
• Time
• Environmental control
• Biological variations

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AFRICIAN AMERICANS

• MORTALITY
• Life Expectancy
• Strokes
• Heart Disease
• Infant Mortality
• Homicide
• HIV/AIDS

13
Health Problems R/T

• Economic status
• poverty
• discrimination
• social and psychological barriers
• Hereditary

14
Communication

• Dialect and language usage
• Modes of behavior
• French, Spanish, Creole

15
Space

• Close Personal Space

16
Social Organization

• Strong church affiliations within community
• Failure to assimilate
• choice
• segregation
• Family System
• female headed household
• large networks

17
Time

• May be present or future oriented, depends on
  assimilation into dominant culture.

18
Environmental Control

• Heterogeneous
• Religious
• prayer and magic
• Folk Medicine
• Internal remedies
• External remedies

19
Biological Variations

• Pallor
• Erythema
• Cyanosis
• Ecchymosis
• Juandice
• Keloids
• Pigmentary disorders
• Pseudofolliculitis
• Melasma

20
Biological Variations

• Lactose intolerance
• Sickle cell anemia
• Genetically inherited
• Alcoholism
• Hypertension
• Cancer of esophagus and stomach

21
HISPANICS

• Second largest emerging majority group
• Fastest growing population
• Mexican
• Puerto Rican
• Cuban
• Other Latin American origin

22
Communication

• Language barrier 50 dialects
• Spanish or Portuguese
• Small talk
• Verbal expression elaborate and indirect
• Eye contact

23
Space

• Tactile
• touch, handshakes, embrace
• Physical presence
• family

24
Time

• Present
• Current activity rather than with planning ahead
  to be on time

25
Environmental Control

• Health is state of harmony and balance
• maintain by diet and keeping four humors in
  balance
• blood
• phlegm
• black bile
• yellow bile

26
Illness as body imbalance

• Illness that are hotare treated with a cold
  substance
• Hot foods cannot be combined, they are to be
  eaten with cold foods
• Hot and cold do not refer to temperature, but are
  a description of a particular substance itself.
• Have to ask the client, varies from person to
  person

27
Curanderismo

• A medical system with historic roots that combine
  Aztec, Spanish, sprititualistic, homeopathic, and
  scientific elements
• Cuandero(a) holistic healer and religious figure

28
Social Organization

• Nuclear families
• Large, extended family networks
• Strong church affiliations within community
• Community social organizations

29
Dislocation of Parts of Body

• Empacho
• Caida de la mollera
• Mal ojo
• Susto

30
Disease and Health Conditions

• Higher rates of obesity and DM
• Lower rates of CVD
• Communicable diseases
• Respiratory TB
• GI diarrhea, Hep. C
• Skin disorders
• HIV

31
Implications

• Reduce access to care barriers
• Reduce communication barriers
• Health promotion messages and health care more
  effective when delivered within their social
  frame of reference
• Focus on problems seen as problems by the
  community
• Involve the community

32
ASIAN AMERICANS

• Chinese (16)
• Filipinos (13)
• Japanese ((10)
• Asian Indian (9)
• Korean (7)
• Other Asian groups (45)

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Communication

• Many languages
• Written verses Oral
• Communicate RESPECT
• Limit use of touch
• Avoid eye contact
• Nonverbal
• Self-control

34
Asian American Space

• Intimate zone confined to private settings
• Noncontact people

35
Social Organization

• Respect traditions
• Family roles well defined
• Role reversal
• Religion
• Buddhism
• Confudianism
• Taoism

36
Time

• Emphasis on the past
• Time as cycles, events, occurrences

37
Environmental Control

• Cultural health practices
• Naturalistic
• Supernaturalistic
• Metaphysical

38
Biological Variations

• Cancer
• stomach, esophagus, liver
• DM diet, lifestyle
• CVD increase with change in diet

39
NATIVE AMERICANS

• 10 different tribes in US
• Cherokee and Navajo are largest

40
Communication

• No common language (tribal language)
• Touch
• Disrespectful to engage in direct eye contact
• Use of silence and body language

41
Space

• Difficult adjusting to unfamiliar spaces
• Value personal space

42
Social Organization

• Family oriented
• Matriarchal society in some tribes
• Guided by supernatural

43
Time

• Present oriented
• Time is casual, and relative to present tasks
  that need to be done in a present time frame

44
Environmental Control

• Native American Healers
• harmony with the environment
• symbolic and sacred items

45
Biological Variations

• DM major health problem
• STD
• Suicide
• Alcoholism
• different enzyme to metabolize alcohol which acts
  quicker and therefore consume more alcohol

46
ARAB AMERICANS

• Major Religion Muslim
• Major Language Arabic
• Health Care Beliefs
• health promotion important
• women hold inferior social position
• same sex health care providers

47
Communication

• For a women, direct eye contact is limited to
  other women or family members
• Males may touch only those women who are in
  family
• Handshakes are continued for a lengthy period
• Educated Saudis respect direct eye contact

48
Social Organization

• Husband is the family leader
• Extended families live together
• The Saudi mother is revered

49
Time

• Time has little meaning except in business
• Social rituals continue while appts. go by
  attended

50
Arab Americans Health

• DM
• Syphilis
• Leprosy
• Cholera
• Rickets and malnutrition
• AIDS

51
MIDDLE ANGLO AMERICANSEnvironmental Control

• Modern, Western health care delivery
• Remaining traditional beliefs
• Folk medicine

52
Biological Variations

• Breast cancer
• Heart disease
• DM

53
Social Organization

• Nuclear families
• Extended families
• Judeo-Christian religions
• Community and social organizations

54
Communication

• National languages
• Many learned English rapidly as immigrants
• Verbal, rather than nonverbal

55
Space

• Noncontact people
• aloof and distant
• Southern countries
• closer contact and touch

56
Time Orientation

• Future over present